Surgical buttress reload and tip attachment assemblies for surgical stapling apparatus
A surgical stapling apparatus includes a handle assembly, an elongate tubular body, a loading unit including an anvil assembly and a staple cartridge assembly, and a reload assembly. The reload assembly includes a staple cartridge releasably disposed within the staple cartridge assembly of the loading unit, a cartridge buttress releasably secured to the staple cartridge, and an anvil buttress including a proximal portion releasably secured to the staple cartridge and a distal portion releasably coupled to the anvil assembly of the loading unit.
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This application claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 62/549,226 filed Aug. 23, 2017, the entire disclosure of which is incorporated by reference herein.
BACKGROUND Technical FieldThe present disclosure relates to surgical stapling apparatus, and more particularly, to reinforced reload attachment assemblies for releasably securing surgical buttresses to surgical stapling apparatus and/or modifying the tip configuration of the surgical stapling apparatus.
Background of Related ArtSurgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of the body tissue together. Such apparatus generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the surgical stapling apparatus is actuated, or “fired”, longitudinally moving firing bars contact staple drive members in one of the jaws. The staple drive members push the surgical staples through the body tissue and into an anvil in the opposite jaw which forms the staples. If body tissue is to be removed or separated, a knife blade can be provided in one of the jaws of the apparatus to cut the body tissue between the lines of staples.
Linear surgical stapling devices are commonly used during surgical procedures to simultaneously seal and cut target tissue, e.g., vasculature, organs, etc. It is not uncommon during such procedures that other tissue, e.g., vasculature or other adherent, connective, or joined tissue, must first be separated from the target tissue before the procedure can continue. Typically, a separate surgical device is used to dissect or separate the other tissue from the target tissue before the target tissue and/or the other tissue is operated upon.
Surgical supports, e.g., meshes or buttress materials, may be used in combination with surgical stapling apparatus to bridge, repair, and/or reinforce tissue defects within a patient such as those occurring, for example, in the abdominal wall, chest wall, diaphragm, or musculo-aponeurotic areas of the body. The surgical support reinforces the staple line as well as covers the juncture of the tissues to reduce leakage prior to healing.
Accordingly, it would be desirable to provide a surgical stapling apparatus that can be used to not only staple and cut tissue but also to separate and dissect tissue and/or to reinforce and seal the staple line.
SUMMARYAccording to an aspect of the present disclosure, a surgical stapling apparatus includes a handle assembly, an elongate tubular body, a loading unit including an anvil assembly and a staple cartridge assembly, and a reload assembly. The reload assembly includes a staple cartridge releasably disposed within the staple cartridge assembly of the loading unit, a cartridge buttress releasably secured to the staple cartridge, and an anvil buttress including a proximal portion releasably secured to the staple cartridge and a distal portion releasably coupled to the anvil assembly of the loading unit.
The proximal portion of the anvil buttress may be releasably secured to a trailing portion of the staple cartridge. The trailing portion of the staple cartridge may be disposed proximally of a tissue facing surface of the staple cartridge. Proximal and distal portions of the cartridge buttress may be releasably secured to the tissue facing surface of the staple cartridge.
The reload assembly may further include an anvil adapter releasably engaged with a distal portion of the anvil assembly. In embodiments, the distal portion of the anvil buttress is releasably secured to the anvil adapter. In some embodiments, the reload assembly further includes a retention member releasably securing the distal portion of the anvil buttress to the anvil adapter, and an anvil knife configured to cut the retention member and release the anvil buttress from the anvil adapter.
The anvil adapter may include a button extending therefrom, the button releasably engaged with an opening extending through the distal portion of the anvil assembly. The anvil adapter may include a protrusion disposed at a distal end thereof, the protrusion releasably engaged with a notch defined in a distal end of the anvil assembly. The anvil adapter may include a tip portion having a curved dissecting tip.
The reload assembly may further include a shipping wedge releasably positioned between the cartridge and anvil buttresses.
According to another aspect of the present disclosure, a reload assembly for a loading unit of a surgical stapling apparatus includes a staple cartridge, a cartridge buttress releasably secured to the staple cartridge, and an anvil buttress including a proximal portion releasably secured to the staple cartridge.
The proximal portion of the anvil buttress may be releasably secured to a trailing portion of the staple cartridge. The trailing portion of the staple cartridge may be disposed proximally of a tissue facing surface of the staple cartridge. Proximal and distal portions of the cartridge buttress may be releasably secured to the tissue facing surface of the staple cartridge.
In embodiments, the reload assembly further includes an anvil adapter releasably attached to a distal portion of the anvil buttress. In some embodiments, the reload assembly further includes a retention member releasably securing the distal portion of the anvil buttress to the anvil adapter, and an anvil knife configured to cut the retention member and release the anvil buttress from the anvil adapter.
The anvil adapter may include a button extending therefrom, the button releasably engageable with an opening defined in an anvil assembly of a loading unit. The anvil adapter may include a protrusion disposed at a distal end thereof, the protrusion releasably engageable with a notch defined in an anvil assembly of a loading unit. The anvil adapter may include a tip portion having a curved dissecting tip.
The reload assembly may further include a shipping wedge releasably positioned between the cartridge and anvil buttresses.
Other aspects, features, and advantages will be apparent from the description, drawings, and the claims.
Various aspects of the present disclosure are described herein below with reference to the drawings, which are incorporated in and constitute a part of this specification, wherein:
Embodiments of the present disclosure are now described in detail with reference to the drawing figures wherein like reference numerals identify identical or similar elements in each of the several views. Throughout this description, the term “proximal” refers to a portion of a structure, or component thereof, that is closer to a user, and the term “distal” refers to a portion of the structure, or component thereof, that is farther from the user. Directional reference terms, such as “top,” “bottom,” “side,” and the like, are intended to ease description of the embodiments and are not intended to have any limiting effect on the ultimate orientations of a structure or any parts thereof.
Referring now to
The handle assembly 10 includes a stationary handle member 12a, a movable handle member 12b, and a barrel portion 14. Actuation of the movable handle member 12b applies lines of staples 60 (
The loading unit 30 is a disposable loading unit (“DLU”) that is releasably secured to the elongated tubular body 20 and thus, replaceable with a new loading unit 30. The loading unit 30 may be a single use loading unit (“SULU”) that is used one time and then replaced to facilitate multiples uses of the surgical stapling apparatus 1 on a patient. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and the entire SULU is replaced after each staple and cut operation of the surgical stapling apparatus 1. The loading unit 30 may be a multi-use loading unit (“MULU”) that is re-useable a predetermined number of times. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and a reload assembly 100 (see e.g.,
As seen in
The staple cartridge assembly 50 includes a cartridge carrier 52 defining an elongated support channel 51 configured and dimensioned to selectively receive and support a staple cartridge 54 therein. The staple cartridge 54 may be removably and/or replaceably attached to the cartridge carrier 52 by, for example, a snap-fit connection, a detent, a latch, among other types of connectors within the purview of those skilled in the art. The staple cartridge 54 includes a support plate 53 and a cartridge body 56 having an inward or tissue facing surface 58 defining staple pockets or retention slots 55 formed therein for receiving a plurality of fasteners or staples 60 and staple pushers 62. A central longitudinal slot 57 is formed in and extends along a substantial length of the cartridge body 56 to facilitate passage of a knife blade 68 therethrough.
The knife blade 68 is defined in a distal edge of a central wall portion 70a of an I-beam 70 that is operatively associated with the tool assembly 34. The central wall portion 70a of the I-beam 70 is slidably disposed between the anvil and staple cartridge assemblies 40, 50, with upper and lower rails 70b, 70c of the I-beam 70, respectively, supported in the anvil and staple cartridge assemblies 40, 50. The I-beam 70 is coupled to an elongated drive beam 72 (
For a detailed description of the structure and function of exemplary surgical stapling apparatus, reference may be made to U.S. Pat. Nos. 6,241,139, 6,330,965, and 7,819,896, the entire contents of each of which are incorporated herein by reference. It should be appreciated that principles of the present disclosure are equally applicable to surgical stapling apparatus having other configurations such as, for example, the types described in U.S. Pat. Nos. 5,964,394, 7,128,253, and 7,334,717, the entire contents of each of which are incorporated herein by reference. Accordingly, it should be understood that a variety of surgical stapling apparatus may be utilized with the reinforced reloads and/or tip attachment assemblies of the present disclosure. For example, laparoscopic or open staplers, such as, for example, GIA™, Endo GIA™, TA™, and Endo TA™ staplers and/or linear and radial reloads with, for example, Tri-Staple™ technology, available through Medtronic (North Haven, Conn.) may be utilized with the surgical buttress reloads and/or tip attachment assemblies of the present disclosure.
With reference now to
The surgical buttresses 110, 120 (also referred to herein as cartridge and anvil buttresses 110, 120) are fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials. It should be understood that any combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials may be used to form the surgical buttresses 110, 120. The surgical buttresses 110, 120 may be formed from the same material or different materials.
The surgical buttresses 110, 120 may be porous, non-porous, or combinations thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and/or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films. The surgical buttresses 110, 120 described herein may be a single porous or non-porous layer, or include a plurality of layers including any combination of porous and non-porous layers. For example, a surgical buttress may include multiple porous and non-porous layers that are stacked in an alternating manner. In another example, a surgical buttress may be formed in a “sandwich-like” manner wherein the outer layers of the surgical buttress are porous and the inner layer(s) are non-porous, or vice versa. The surgical buttresses 110, 120 may have the same or a different structure of layer(s).
Porous layer(s) in a surgical buttress may enhance the ability of the surgical buttress to absorb fluid, reduce bleeding, and seal a wound. Also, the porous layer(s) may allow for tissue ingrowth to fix the surgical buttress in place. Non-porous layer(s) in a surgical buttress may enhance the ability of the surgical buttress to resist tears and perforations during the manufacturing, shipping, handling, and stapling processes. Also, non-porous layer(s) may retard or prevent tissue ingrowth from surrounding tissues thereby acting as an adhesion barrier and preventing the formation of unwanted scar tissue.
The plurality of retention members 130a-d (also referred to herein as first, second, third, and fourth retention members 130a-130d) are fabricated from biocompatible materials which are any combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials. Each of the retention members 130a-130d is a single continuous elongated structure, and may be in the form of a suture, thread, filament, tether, strap, band, line, wire, cable, etc.
With continued reference to
The anvil buttress 120 includes a body portion 122 configured and dimensioned to overlie the tissue facing surface 46 (
The staple cartridge 54 includes a third pair of recesses 59c formed in opposed side edges of a trailing portion 54c of the staple cartridge 54, which is disposed proximally of the tissue facing surface 58 of the staple cartridge 54. The tail portion 124 of the anvil buttress 120 is configured and dimensioned to overlie the trailing portion 54c of the staple cartridge 54 and is releasably attached thereto via the third retention member 130c which is retained within the third pair of recesses 59c and extends across the tail portion 124 of the anvil buttress 120 and a path of the knife blade 68 (
A distal portion 120b of the anvil buttress 120 is releasably secured to the anvil adapter 140 via the fourth retention member 130d. As shown in
As shown in
The elongated rod 152 and the plate body 154a of the anvil knife 150 are positionable within a recess 145 defined in the tissue facing surface 142b of the anvil adapter 140 such that the pair of wings 154b of the anvil knife 150 project into the pair of elongated openings 143b of the anvil adapter 140. The anvil knife 150 is longitudinal movable relative to the anvil adapter 140 between proximal and distal positions within the confines of the recess 145 and the elongated openings 143b of the anvil adapter 140.
The fourth retention member 130d is threaded through the pair of recesses 143a of the anvil adapter 140 such that a portion of the fourth retention member 130d crosses the tissue facing surface 142b of the anvil adapter 140 and the plate body 154a of the anvil knife 150 (see e.g.,
The anvil adapter 140 further includes a button 146 extending outwardly from the anvil facing surface 142b of the body portion 142. The button 146 is configured to releasably engage the opening 45 (
With reference again to
In a method of loading the reload assembly 100 onto the loading unit 30, as shown, for example, in
In operation, with the reload assembly 100 loaded onto the loading unit 30, as described above, and the shipping wedge 160 removed therefrom, the surgical stapling apparatus 1 is used in accordance with methods known by those skilled in the art. Once the anvil and staple cartridge assemblies 40, 50 are clamped onto tissue, the surgical stapling apparatus 1 is fired. In firing the surgical stapling apparatus 1, the drive beam 72 is advanced distally through the tool assembly 34 urging the staple pushers 62 upwardly which, in turn, drive the staples 60 out of the staple pockets 55 of the staple cartridge 54 and through the surgical buttresses 110, 120 as well as the captured tissue, thereby stapling the surgical buttresses 110, 120 to the tissue. The knife blade 68 substantially simultaneously cuts and divides the tissue and the surgical buttresses 110, 120 disposed between the rows of now formed staples 60.
During firing, as shown in
As the knife blade 68 continues to travel distally, as shown in
When firing is complete and the anvil and staple cartridge assemblies 40, 50 are unclamped, the anvil and cartridge buttresses 120, 110, which are now stapled to the tissue, pull away from the anvil and staple cartridge assemblies 40, 50, and the tool assembly 34 is removed from the surgical site. The used reload assembly 100 may then be removed from the tool assembly 34 by removing the staple cartridge 54 from the staple cartridge assembly 50 and the anvil adapter 140 from the anvil assembly 40.
As shown in
An anvil adapter 240 in accordance with another embodiment of the present disclosure is shown in
The anvil adapter 240 further includes a tip portion 248 configured and dimensioned to provide the loading unit 30 with a curved tip to enhance visualization and/or maneuverability of the tool assembly 34 around target tissue and/or vessels. The tip portion 248 of the anvil adapter 240 may aid in tissue manipulation, allowing for blunt tissue dissection and/or mobilization. Other configurations of the tip portion 248 are envisioned depending upon, for example, the desired characteristics of the tool assembly 34 as should be understood by those skilled in the art. Accordingly, it should be understood that a clinician can customize a loading unit to have a desired configuration for a particular surgical procedure and/or patient. It should be further understood that the reload assembly 100 may be used with anvil adapters having a variety of configurations. For example, the anvil adapter 140 of the reload assembly 100 may be modified to include the tip portion 248 of the anvil adapter 240. Accordingly, a variety of combinations of the components of the reloads and/or anvil adapters are envisioned.
It should be further understood that while the reload assembly 100 is shown including both cartridge and anvil buttresses 110, 120, the reload assembly 100 may include only the cartridge buttress or the anvil buttress 120 depending on, for example, the surgical application and/or the desired placement of the buttress material relative to tissue as should be understood by those skilled in the art.
The surgical buttress reloads and tip attachment assemblies described herein may also be configured for use with other surgical apparatus, such as electromechanical surgical devices as described, for example, in U.S. Pat. Appl. Pub. Nos. 2015/0157320 and 2015/0157321, the entire contents of each of which are incorporated herein by reference. Furthermore, the surgical stapling instrument could be configured for use in a surgical robotic system.
In any of the embodiments disclosed herein, a removable and replaceable staple cartridge can be provided for use with a surgical reload, or a surgical stapling instrument having a jaw attached to an elongate portion, without a loading unit that has an portion removably attachable to the elongate portion of a handle. In any of the embodiments disclosed herein, the surgical buttress can be made from a melt blown bioabsorbable material, such as polyglycolic acid, polylactic acid, glycolide trimethylene carbonate, and polycaprolactone. The surgical buttress can include, be coated with, or otherwise deliver a bioactive material, such as a medicament, hemostat, growth factors, chemotherapy agent, or other such materials.
While the surgical stapling apparatus of the present disclosure are shown firing staples, it should be understood that the surgical stapling apparatus may be adapted to fire other fasteners, such as clips, two-part fasteners, among other suitable fasteners within the purview of those skilled in the art.
Persons skilled in the art will understand that the systems, devices, and methods specifically described herein and illustrated in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, it is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another exemplary embodiment without departing from the scope of the present disclosure, and that such modifications and variations are also intended to be included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not to be limited by what has been particularly shown and described.
Claims
1. A surgical stapling apparatus comprising:
- a handle assembly;
- an elongate tubular body;
- a loading unit including an anvil assembly and a staple cartridge assembly; and
- a reload assembly including:
- a staple cartridge releasably disposed within the staple cartridge assembly of the loading unit;
- an anvil adapter including a body having a button extending therefrom that is engaged with an opening extending through a distal portion of the anvil assembly and accessible through an outermost surface of the anvil assembly to releasably attach the anvil adapter to the anvil assembly;
- a cartridge buttress releasably secured to the staple cartridge; and
- an anvil buttress including a proximal portion releasably secured to the staple cartridge and a distal portion releasably secured to only the body of the anvil adapter such that the distal portion of the anvil buttress is retained on the anvil assembly when the anvil adapter is engaged with the anvil assembly.
2. The surgical stapling apparatus according to claim 1, wherein the proximal portion of the anvil buttress is releasably secured to a trailing portion of the staple cartridge, the trailing portion disposed proximally of a tissue facing surface of the staple cartridge.
3. The surgical stapling apparatus according to claim 2, wherein proximal and distal portions of the cartridge buttress are releasably secured to the tissue facing surface of the staple cartridge.
4. The surgical stapling apparatus according to claim 1, wherein the reload assembly further includes a retention member releasably securing the distal portion of the anvil buttress to the anvil adapter, and the anvil adapter includes an anvil knife slidable relative to the body of the anvil adapter and configured to cut the retention member and release the anvil buttress from the anvil adapter.
5. The surgical stapling apparatus according to claim 1, wherein the anvil adapter includes a protrusion disposed at a distal end thereof, the protrusion releasably engaged with a notch defined in a distal end of the anvil assembly.
6. The surgical stapling apparatus according to claim 1, wherein the anvil adapter includes a tip portion having a curved dissecting tip.
7. The surgical stapling apparatus according to claim 1, wherein the reload assembly further includes a shipping wedge releasably positioned between the cartridge and anvil buttresses.
8. The surgical stapling apparatus according to claim 7, wherein the shipping wedge includes a distal end complementary in shape with the button to facilitate release and removal of the anvil adapter from the anvil assembly.
9. The surgical stapling apparatus according to claim 1, wherein the button of the anvil adapter includes a shank and an enlarged head, and a channel is defined in the button such that portions of the button on opposed sides of the channel can flex relative to each other.
10. A reload assembly for a loading unit of a surgical stapling apparatus, the reload assembly comprising:
- a staple cartridge configured for positioning in a staple cartridge assembly of the loading unit;
- an anvil adapter including a body having a button extending therefrom configured for engaging an opening defined in a distal portion of an anvil assembly of the loading unit and extending through an outermost surface of the anvil assembly to releasably attach the anvil adapter to the loading unit;
- a cartridge buttress releasably secured to the staple cartridge; and
- an anvil buttress including a proximal portion releasably secured to the staple cartridge and a distal portion releasably secured to only the body of the anvil adapter such that the distal portion of the anvil buttress is retained on the anvil assembly when the anvil adapter is engaged with the anvil assembly.
11. The reload assembly according to claim 10, wherein the proximal portion of the anvil buttress is releasably secured to a trailing portion of the staple cartridge, the trailing portion disposed proximally of a tissue facing surface of the staple cartridge.
12. The reload assembly according to claim 11, wherein proximal and distal portions of the cartridge buttress are releasably secured to the tissue facing surface of the staple cartridge.
13. The reload assembly according to claim 10, further including a retention member releasably securing the distal portion of the anvil buttress to the anvil adapter, and the anvil adapter includes an anvil knife slidable relative to the body of the anvil adapter and configured to cut the retention member and release the anvil buttress from the anvil adapter.
14. The reload assembly according to claim 10, wherein the anvil adapter includes a protrusion disposed at a distal end thereof, the protrusion releasably engageable with a notch defined in an anvil assembly of a loading unit.
15. The reload assembly according to claim 10, wherein the anvil adapter includes a tip portion having a curved dissecting tip.
16. The reload assembly according to claim 10, further including a shipping wedge releasably positioned between the cartridge and anvil buttresses.
17. The reload assembly according to claim 16, wherein the shipping wedge includes a distal end complementary in shape with the button to facilitate release and removal of the anvil adapter from the anvil assembly.
18. The reload assembly according to claim 10, wherein the button of the anvil adapter includes a shank and an enlarged head, and a channel is defined in the button such that portions of the button on opposed sides of the channel can flex relative to each other.
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Type: Grant
Filed: Jul 17, 2018
Date of Patent: Mar 16, 2021
Patent Publication Number: 20190059896
Assignee: COVIDIEN LP (Mansfield, MA)
Inventor: John Beardsley (Wallingford, CT)
Primary Examiner: Anna K Kinsaul
Assistant Examiner: Chinyere J Rushing-Tucker
Application Number: 16/037,367
International Classification: A61B 17/64 (20060101); A61B 17/072 (20060101); A61B 17/064 (20060101); A61B 17/00 (20060101); A61B 17/32 (20060101); A61B 90/00 (20160101);